Improving Floating Satisfaction for Nurses in a Pediatric Intensive Care Unit

Purpose:
Based on the 2009 NDNQI RN Survey only 57% of respondents in the Pediatric Intensive Care Unit felt they were floated to an area of competence. The PICU Nurse Practice Council (NPC) addressed floating practices to the Pediatric Cardiovascular ICU (CICU) in order to improve competence.

Significance:
Floating has been an area of conflict in nursing for several years. Although this practice may help with staffing and budget, it can often be a negative experience for a nurse who is sent out of their comfort zone.

Strategy and Implementation:
Based on additional survey results and a fishbone diagram created by the PICU NPC, it was determined that floating dissatisfaction could be divided into two categories: comfort and competence, both of which were directly related to satisfaction. These areas were addressed by developing a CICU orientation day for new PICU nurses, which was adopted by the leadership team of CICU, and creating a cardiac resource book for PICU nurses.

Evaluation:
Based on the 2010 NDNQI RN Survey, the percentage of nurses floating to an area of competence increased from 57% to 75%. Follow up surveys also reflected more positive floating experiences to the CICU. All new PICU nurses, including GNs and transfers, have had CICU orientation since April 2010.

Implications for Practice:
Improving floating satisfaction has the potential to improve overall nursing satisfaction as well as patient outcomes. Nurses must feel both competent and comfortable in their area of practice in order to provide the highest quality care.